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Two students enrolled in the Physician Assistant program at Methodist University in Fayetteville, North Carolina, will do a one-month volunteer clinical residency at the public health clinic in Teotitlan del Valle, Oaxaca, this summer. Meagan Parsons and Benjamin Cook, who will both graduate in December 2013, land in Oaxaca next week! Needless to say, they are excited.

And, we are grateful for their service. They will work alongside local doctors, nurses, and other clinicians to support delivery of primary health care services to a rural and growing village of 8,000 people.

For those of you who don’t know, Physician Assistants (PA’s) are master’s degree prepared health care professionals who are trained to practice as part of a physician-led team. This is usually a two-year program that includes a first year of classroom coursework followed by a second year of clinical rotations.

Nurse Practitioners (master’s prepared nurses who provide direct patient care) and PA’s are meeting the demands of our U.S. health care system, especially in underserved areas where there is a lack of adequate medical services. Immigrant populations who speak Spanish and have cultural impressions of a health care system that hasn’t always provided access to quality treatment benefit from these professional services.

Both Ben and Meagan speak Spanish and the experience will give them a chance to improve their language skills and learn more about how health care is delivered in rural Mexico. What they learn will help them translate the experience to their own professional goals to work in rural North Carolina communities after they graduate.

Meagan graduated from The University of North Carolina at Chapel Hill in 2009 with an undergraduate degree in biology and a minor in Spanish for health care professionals. She worked as a nursing assistant in a pediatric surgical unit before she decided to go on for the P.A. degree. This will be her first trip to Mexico and Meagan is eager for the immersion experience that she knows will give her a greater understanding for the emotional and cultural issues facing North Carolina’s immigrants. When she graduates from Methodist, she plans to return to Rockingham County where she will practice in a small-scale rural community working with Spanish-speaking populations.

Ben Cook completed his undergraduate degree in human biology and Spanish from North Carolina State University in 2011. He always wanted to pursue a medical career and he wanted more time to have a family and be involved with family life. He feels that by becoming a P.A., he will have the best of both worlds. He chose Methodist University because it has a high pass rate on the national certifying examination and there is a dedicated laboratory for student use. Like most men who pursue a career in health care, Ben wants to go to work in either the Emergency Department or in Urgent Care where the fast-paced excitement prevails. He feels the Oaxaca experience will give him better ways to connect with patients here in the U.S.

Deborah Morris, M.D., P.A., is the faculty member who supervises the cultural immersion program in Teotitlan del Valle for Methodist University. She says this experience is essential for giving students a broader perspective of the world and the ways that health care is delivered in a system that is different than ours in the U.S. She says, There is a flow of people between Oaxaca and North Carolina. It is helpful for students to have this experience to be more effective as P.A.’s.

For the village of Teotitlan del Valle, the students will trail and support the work of Mexican doctors, nurses, social workers, psychologists and dentists. They will start out doing basic health assessments and physical diagnosis, assist in giving innoculations, and update handwritten medical records. As they get to know the population and their needs, they will develop a health education project with local participation and input, that can be used for continuing health care improvement. The biggest health care issues in Oaxaca are women’s and children’s health, pre-natal care, diabetes and its prevention, and cancer treatment.

Meagan and Ben will overlap with UNC Chapel Hill School of Nursing student Leonora Tisdale who arrived to volunteer in the clinic in early June. I am so gratified to be able to organize this experience that benefits the students, the people of Teotitlan del Valle, and people here in the U.S. who will be better served as a result of Leonora, Meagan and Ben’s immersion.

I work with universities to place students in the health professions for a volunteer experience in the Teotitlan del Valle public health clinic. Please contact me for more information.

Aside from organizing arts workshops in Oaxaca, Mexico, I also work with universities to place students pursuing a health care degree in the Teotitlan del Valle public health clinic for student exchange externship experiences. I started doing this during the ten years I worked at The University of North Carolina at Chapel Hill School of Nursing. This gives me a great deal of pleasure and personal satisfaction because of its positive impact on people. This is international cultural and health care education that can change lives.

In a week from now, Leonora Tisdale, a thirty-two year old second degree nursing student at The University of North Carolina at Chapel Hill, will spend a month volunteering in the clinic, which serves the primary care needs of eight thousand residents, plus those who come from smaller villages nearby.

Leonora is bilingual, a trained doula, and holds an undergraduate degree from Guilford College. She is interested in learning more about the medical culture of Mexico and its standard of care, maternal childbirth practices and women’s health. After she returns, she will do a North Carolina clinical rotation at a rural clinic that serves immigrant families from Mexico and Central America. Neither the professionals in or patients accessing the Teotitlan del Valle clinic speak much, if any, English. This will give Leonora a perfect opportunity to build her medical Spanish vocabulary as she prepares for her nursing career.

When we met for coffee yesterday, Leonora said she is excited and energized. She has prepared well by reading about Oaxaca health care needs: the mental health issues around migration and being left behind, why indigenous women choose traditional birth methods, and the stigma of HIV-AIDS. She wants to build relationships with the people who live in the village and learn the cultural nuances that one can only get by being there. And, of course, she wants to eat all seven Oaxaca moles (though, I suspect, not at the same time!). At the end of her service, Leonora will write a reflection paper about her experience and I hope to publish it here.

One of the public health officials of the village tells me that better health care is a priority for Teotitecos. The externships not only provide a cultural exchange, they give the clinic doctors, nurses, psychologist, and social worker clinical help in an overburdened system where the population is growing and there are not enough providers. I explained to Leonora that diabetes occurrence is high in the region and there are health education opportunities working with local people to sustain programs around nutrition and exercise, and maternal and child health, and other chronic illnesses.

Students and/or university faculty members work with me directly to make the arrangements for student volunteer service. I facilitate the residency and make arrangements with those in the village. Students work directly with their universities for academic credit, travel and insurance requirements.

At the end of June, two physician assistant students — Ben Cook and Meagan Parsons — from Methodist University in Fayetteville, NC, will begin their month-long externship at the Teotitlan del Valle clinic. They will be joined by Professor Deborah Morris, MD, PA-C, who will be the on-site supervisor of their experience.

I welcome inquiries to arrange for spring break, winter intercession, and summer externships. We ask that students be enrolled in a four-year academic institution, have at least one year of Spanish language proficiency to participate, be an excellent student, and participate as part of their academic experience for academic credit with the supervision (on-site or remotely) of a faculty member.

For more information, contact Norma Hawthorne at normahawthorne@mac.com (copy and paste my email address into your email program if you can’t get the link to work. It’s funky today!).

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Norma Schafer and Oaxaca Cultural Navigator LLC has offered programs in Mexico since 2006. We have over 30 years of university program development experience. See my resume.

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